What is a development assessment?

An assessment is a structured evaluation of your child's development—physical, language, intellectual, social, and emotional—by a developmental assessment specialist, or a team of professionals that can include a pediatrician, language specialist, audiologist, occupational therapist, child psychologist, and a physical therapist, among others.

Your assessment will be tailored to your child's age and suspected problem or delay. In general, you can expect that you'll spend time answering a host of detailed questions about your child's growth, physical movements, behavior, play, and interactions with family members and the rest of the world. And your child will undergo a series of tests that may include a physical exam, hearing and eye screenings, play observation, and standardized tests that present your child with certain tasks to determine areas of strength and weakness.

If someone has recommended that your child get an assessment, you may be feeling anxious, scared, or even guilty. No parent likes to hear that her child has a problem. It's normal to be concerned, but remember that an assessment is simply an evaluation of your child. It is not a diagnosis in and of itself (though it may lead to one), nor a sign that something is seriously wrong.

In many cases, an assessment reveals that the child is absolutely normal and needs no further treatment (the doctor may give you suggestions on how to work with your child). Keep an open mind about the process and you and your child can only benefit.

How do I know whether my child needs one?

Your child's doctor will informally monitor your baby's development at each well-child visit. If he notices an area where your child seems to be lagging significantly behind his peers, he may refer you to a developmental specialist for an assessment.

As a parent, you too can be the driving force behind an assessment. In fact, parents are often the first to notice developmental delays because they know their children best. A doctor spends only a few minutes with your child at each visit, so it's easy for him to miss subtle problems.

If you're worried about a particular issue, your child's speech or ability to grab objects, for instance, and the doctor doesn't mention anything, bring it up and ask for a referral to a specialist.

If your child is in a daycare center with staff trained in early childhood development, a caregiver may suggest you take your child for an assessment.

What are the signs of a good assessment?

Every assessment is different because every child and family are different. The best share the following characteristics, according to Zero to Three, a nonprofit organization devoted to the physical and mental health of young children, and a leader in establishing professional standards for child assessments.

Parents and professionals should work together. You are an expert on your child's behavior and should play a key role in the evaluation process. Your information and opinions are crucial in determining how your child is really doing.

The assessment should be conducted by a team that can include a pediatrician, audiologist, child psychologist, and physical therapist, among others, to get a complete picture of your child's skills. The members of the team should all have a solid understanding of child development.

Your child should be observed in a number of settings with different people. Behavior is complicated. To get a complete picture of how your child plays, learns, reasons, moves, interacts, etc., he needs to be evaluated in different surroundings. How he acts with you, for instance, may differ from how he is at daycare or with his siblings. A good assessment team will take all these things into consideration.

The process should identify your child's strengths and weaknesses. Child development is very complex, and a good assessment should take into consideration how your child is functioning in a number of areas, not just the one or two that he seems to be having trouble with.

Your child should not be forced to separate from you during testing. You can't expect a baby or young child to function at his best if he's anxious about being separated from his parents.

An assessment should feel like help. A formal evaluation of your child's development is often the first step in determining whether he needs early intervention or treatment. But when the testing is done well, many parents say that's helpful in itself. During the process you should feel like your knowledge of your child is growing, and you're getting new ideas on how to interact with your child and answers to many of your development questions. You may even feel some sense of relief. Being faced with a potential development problem can be upsetting, but knowing that help is available can give you hope.

How can I ensure the best results for my child?

Preparing for an assessment and being an advocate for your child are the two most important things you can do to ensure optimal test results. Here are a few specific pointers:

Both parents should attend any meetings or screening exams, if possible. You may have different information or ideas to contribute, and you can compare notes later to make sure you understand everything that took place.

Make sure your child is healthy and comfortable during testing. A child who is scared, or has a cold or ear infection, for example, won't perform at his best.

Ask for a written report at the conclusion of the assessment. Ask questions about anything you don't understand, and don't be afraid to disagree and ask for further discussion on the points you have issues with. Accepting an assessment that you think is off the mark won't do you or your child any good.

Consider getting a second opinion before starting an intervention program. Treatment can be costly, time consuming, and emotionally draining for you and your child. Before you commit to it, get a diagnosis.

Have your child reassessed periodically. Children grow and develop so rapidly and at such different rates, it's important to reevaluate them regularly. Your child may outgrow a delay or develop new ones. Continued monitoring will catch any changes.

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